title: Staphylococcal vaccine development: review of past failures and plea for a future evaluation of vaccine efficacy not only on staphylococcal infections but also on mucosal carriage.
abstract: Staphylococcal disease represents a universal burden including acute, life-threatening infections as well as chronic infections usually associated with foreign materials. Infections occur notably in permanent carriers of Staphylococcus aureus. To date, all the attempts to develop an efficacious vaccine against S. aureus have failed. Failures in vaccine clinical trials might be related to a focus on single targets and development of humoral-based vaccines rather than vaccines with a combination of antigens stimulating both humoral and cellular immunity. The end points of these unsuccessful trials were a reduction in mortality or bacteremia, whereas the patient's decolonization was not assessed. Adopting the latter point of view, the aim of this article is to discuss nasal mucosal decolonization as a complementary marker of vaccine efficacy for clinical research in vaccine development.
authors.affiliation: Groupe Immunité Muqueuse et Agents Pathogènes, EA 3064, PRES Lyon, Université Jean Monnet et CHU de Saint-Etienne, 42023 Saint-Etienne, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Botelho-Nevers
authors.forename: Paul
authors.initials: P
authors.lastname: Verhoeven
authors.forename: Stephane
authors.initials: S
authors.lastname: Paul
authors.forename: Florence
authors.initials: F
authors.lastname: Grattard
authors.forename: Bruno
authors.initials: B
authors.lastname: Pozzetto
authors.forename: Philippe
authors.initials: P
authors.lastname: Berthelot
authors.forename: Frederic
authors.initials: F
authors.lastname: Lucht
mesh_terms: D016470:Bacteremia / Q000517:prevention & control; D002353:Carrier State / Q000276:immunology / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D006801:Humans; D013203:Staphylococcal Infections / Q000276:immunology / Q000517:prevention & control*; D013209:Staphylococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology* / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000276:immunology*; D016019:Survival Analysis
chemical_list: D013209:Staphylococcal Vaccines